BACKGROUND: Given the prevalence of osteoarthritis and the growing interest in alternative treatments, there is a need to provide a comprehensive evaluation of this integrated TCM approach. Reviews are required to understand the potential benefits and safety of the combination therapy compared to conventional treatments. Hence, this meta-analysis investigates the effectiveness of combining Thunder Fire Moxibustion with other Traditional Chinese Medicine (TCM) modalities, specifically acupuncture and herbal formulas, in treating knee osteoarthritis.
METHODS: A comprehensive literature search across databases like PubMed Central, EMBASE, MEDLINE, and others was conducted. The inclusion criteria focused on randomized controlled trials involving patients with knee osteoarthritis, comparing the effectiveness of Thunder Fire Moxibustion combined with other TCM modalities against standard care. The Cochrane Risk of Bias tool was used for bias assessment, and a random-effects inverse-variance model for meta-analysis.
RESULTS: Out of 1467 records, 7 studies met the inclusion criteria. The pooled Risk Ratio (RR) for total effective rate was 1.119, indicating a significant effect of the combined TCM treatment. Subgroup analysis showed a pooled RR of 1.130 for acupuncture combinations and 1.103 for herbal TCM combinations. The incidence of adverse reactions had a non-significant pooled RR of 0.572. The GRADE assessment indicated a low overall quality of evidence due to risks of bias and publication bias.
CONCLUSION: The combination of Thunder Fire Moxibustion with other TCM modalities shows potential effectiveness in treating knee osteoarthritis, with minimal adverse reactions. However, the low quality of evidence suggests a need for more rigorous studies to confirm these findings.
| Discipline Area | Score |
|---|---|
| Physician |  |
Physician rater
Meta-analysis of traditional Chinese medicine and thunder fire moxibustion in OA. Limited evidence of benefit from poorly controlled trials.
Physician rater
Combining Thunder Fire Moxibustion with other traditional Chinese medicine (TCM) modalities, mainly acupuncture and herbal formulas, appears to be more effective than standard care or Western medicine alone for treating knee osteoarthritis, with minimal evidence of increased adverse reactions. However, due to methodological limitations such as small sample sizes, unclear randomisation processes, lack of blinding, incomplete outcome data and publication bias, the quality of the evidence is low. More rigorous, high-quality RCTs are needed to confirm these findings before strong clinical recommendations can be made.
Physician rater
The meta-analysis suggests that for knee osteoarthritis, Thunder Fire Moxibustion combined with acupuncture or herbal formulas provides greater pain relief than conventional Western treatments. However, the reliability of this conclusion is limited by the low quality of the available evidence. Further high-quality studies are required to reach definitive conclusions.
, McMaster University